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Post-Decisional Administrative Review Process

Placeholder for IC Instrument

OMB: 0596-0231

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Post-Decisional Administrative Review Process

0596-0231





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The appellant must provide: the appellant’s name, mailing address, daytime telephone number, and e-mail address. They must also provide a statement of how the appellant is adversely affected by the decision being appealed; a statement of the relevant facts underlying the decision being appealed; a discussion of issues raised by the decision being appealed; a statement as to whether and how the appellant has attempted to resolve the issues under appeal with the Responsible Official; a statement of the relief sought; the signature of the appellant.



This information can be submitted in any format convenient to the appellant.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorWolf Cota
File Modified0000-00-00
File Created2023-09-20

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